On-pump versus off-pump - A comparison of two surgical techniques with special regard to perioperative complications: a prospective randomized trial

Die Studie vergleicht die operative Koronarrevaskularisation mit und ohne Herz-Lungen-Maschine hinsichtlich allgemeiner und insbesondere neurologischer Komplikationen.Comparison of surgical coronary revascularization with and without heart-lung machine concerning common and especially neurological complications

Cyclo-P4 Ligands with a Maximum of Electron-Donating Ability

The reactions of P4 with metal carbonyls of chromium, tungsten and iron lead to square planar cyclo-P4 ligand complexes and to a rectangular distorted P4 ligand complex, respectively. Furthermore the study of the transformation pathway of tetrahedral P4 to the corresponding Px ligands reveals a stepwise (PP) bond cleavage with a bicyclotetraphosphine intermediate to give a cyclo-P4 containing product

Dreikomponentenreaktionen unter photochemischen Bedingungen--der Transformationsweg des P4-Phosphors in der Koordinationssphäre von Co-Komplexen

Die Photolyse von [CpxCo(CO)2] (Cpx = Cp, Cp′, Cp″, Cptriple prime, Cp5; Cp = η5-C5H5, Cp′ = η5-C5Ht4Bu, Cp″ = η5-C5Ht3Bu2, Cptriple prime = η5-C5Ht2Bu3, Cp5 = η5-C5Ph5) mit P4-Phosphor bei Raumtemperatur in Gegenwart von [Cr(CO)5(THF)] liefert die Bicyclotetraphosphankomplexe [CpxCo(CO)(η1:1-P4){Cr(CO)5}4] (1: Cpx = Cp, 2: Cpx = Cp′, 3: Cpx = Cp″). Als Hauptprodukte werden die cyclo-P4-Ligandkomplexe [CpxCo(η4-P4){Cr(CO)5}4] (4: Cpx = Cp, 5: Cpx = Cp′) bzw. [CpxCo(η4-P4){Cr(CO)5}3](6: Cpx = Cp″, 7: Cpx = Cptriple prime, 8: Cpx = Cp5) isoliert. Untersuchungen des Reaktionsweges zeigen, daß sich im ersten Schritt die Bicyclotetraphosphankomplexe 1-3 bilden, aus denen nach CO-Abspaltung und (P-P)-Bindungsbruch die cyclo-P4-Ligandkomplexe 4-8 entstehen. Sowohl das Koordinationsverhalten des cyclo-P4-Liganden als auch die nichtparallele Anordnung der P4- und Cpx-Ringe hängt von der Natur der organischen Substituenten am Cpx-Liganden ab. Der Neigungswinkel zwischen der P4- und Cpx-Ebene steigt in der Reihe Cpx = Cp″ < Cptriple prime < Cp5 von 4 auf 9°. Temperaturabhängige 31P-NMR-Studien ergeben verschiedene Rotationsbarrieren in Abhängigkeit vom jeweiligen Cpx-Liganden (6: ΔG≠Tc = 39.1 kJ mol−1). 7 und 8 zeigen in Lösung eine hohe Tendenz [Cr(CO)5]-Gruppen abzuspalten. Auf diese Weise werden Verbindungen mit nur zwei bzw. einer [Cr(CO)5]-Einheit gebildet

The Reaction Behavior of White Phosphorus with Metal Complexes of Cobalt and Molybdenum

Studies of the reaction pathway of tetrahedral P4 with cobalt- and molybdenum coordination compounds lead to novel complexes containing PX-ligands (x = 2,4) in unusual binding modes

The reaction of P4 with [Cp′Mo(CO)3]2 (Cp′ = η5-C5H4tBu)—the structure of [Cp′Mo(CO)2<(η3-P4){Cr(CO)5}4(H)>]

The photochemical reaction of [Cp′Mo(CO)3]2 (Cp′ = η5-C5H4tBu) with white phosphorus in the presence of [Cr(CO)5thf] leads to the Pn ligand complexes [Cr(CO)4 ;] (1), [Cp′Mo(CO)2] (2) and [{Cp′Mo(CO)2}2] (3). The products were characterized by NMR, IR and partially by X-ray structure analysis. The reaction proceeds via a P---P bond cleavage leading to the bent cyclo-P4 complex [Cp′Mo(CO)2] (2a), which hydrolysis during the chromatographic work-up to give the more stable compound 2. Furthermore, a P3/P1 fragmentation of 2a occurs to form the phosphido complex intermediate [CP′CO)2Mo---P → Cr(CO)5]. The latter dimerises resulting in the formation of the tetrahedral compound 3, containing a Mo2P2 moiety

Different Ways of P4 Transformation in the Coordination Sphere of Transition Metals

The transformation pathway of tetrahedral P4 to the corresponding Pn ligands has been studied by the three-component-reaction are found to depend on the electron number of the complex fragments used. In the case of complexes forming fragments with an even number of valence electrons, a stepwise P-P bond cleavage is observed with a bicyclotetraphosphine intermediate to give a cyclo-P4 containing product. Complexes with an odd number of valence electrons cause a P1/P3 fragmentation. A possible product of this reaction is a phosphido complex of the type [LnM≡P→M'(CO)5] (M' = Cr, W), which is self-stabilised by dimerisation. The phosphido complex [(tBuO)3W≡P→M(CO)5] (M = Cr, W) is formed via the reaction of W2(OtBu)6 with RC≡P in the presence of the Lewis acids [M(CO)5THF]

Podoplanin expression predicts prognosis in patients with oral squamous cell carcinoma treated with neoadjuvant radiochemotherapy

Despite new therapeutic approaches patients with advanced oral squamous cell carcinoma still have a dismal prognosis. The main factor contributing to this problem is locoregional failure due to a lack of response to treatment. Several trials have proven the effect of neoadjuvant radiochemotherapy followed by radical surgery in comparison to primary surgery followed by adjuvant radiochemotherapy. No reliable parameters have been identified so far to predict response to radiochemotherapy. The aim of our study was to assess whether podoplanin expression in pretreatment biopsies could serve as a biomarker to predict the host response to neoadjuvant radiochemotherapy. In this retrospective study, podoplanin expression was examined in a set of 63 patients with oral squamous cell carcinoma by immunohistochemistry. We analyzed associations between the level of podoplanin expression and various clinicopathologic parameters, including response to radiochemotherapy, clinical and histological N-status. Furthermore we evaluated the effects of these parameters on overall survival and on locoregional control in univariate and multivariate analysis. The chi(2)-test revealed that high expression of podoplanin in pretreatment biopsy material was associated with non-regression of the tumor (p = 0.013) and poor overall survival (p < 0.001). Five-year survival rates of 92.9% for patients with weak expression and 15.0% for high expression were revealed. Podoplanin expression was also significantly associated with ypN status (p = 0.004) and ypUICC status (p < 0.001). We concluded that podoplanin might serve as a factor to predict treatment response in oral squamous cell carcinoma treated with neoadjuvant platin-based radiochemotherapy as well as a prognostic factor for overall survival and locoregional control. (C) 2011 Elsevier Ltd. All rights reserved

PROGNOSTIC IMPACT OF DIFFERENT TNM-BASED STAGE GROUPINGS FOR ORAL SQUAMOUS CELL CARCINOMA

Background. The purpose of this study was to evaluate the prognostic significance of different TNM-based stage groupings proposed in the literature. Methods. We conducted a retrospective analysis of 300 patients with primary oral squamous cell carcinoma (T1-4, N0-2, M0). The stage grouping systems of the sixth edition of the Union Internationale Contre le Cancer (UICC), T and N Integer Score (TANIS), the Snyderman scheme, the Hart scheme, and the Berg scheme were tested for their prognostic significance. Disease free survival (DFS) was plotted by Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analysis. Results. On univariate analysis, all systems revealed discriminatory power for DFS; however, on multivariate analysis, only the Hart scheme predicted DFS. The TANIS did not have a better prognostic ability than the UICC stage grouping. Conclusion. Unlike in previous studies, the UICC stage grouping did perform worse than other TNM-based stage groupings, which may be due to the alterations made in the sixth edition. (C) 2010 Wiley Periodicals, Inc. Head Neck 33: 1467-1475, 201

Combined-modality treatment in advanced oral squamous cell carcinoma Primary Surgery Followed by Adjuvant Concomitant Radiochemotherapy

Background: The efficacy of adjuvant radiochemotherapy (RCT) in patients with advanced stage head and neck carcinoma has been proven in prospective randomized trials. However, these trials focused on different head and neck sites. Specific analyses for treatment effects in squamous cell carcinoma of the oral cavity (OSCC) are missing. We evaluated our experiences with adjuvant concomitant RCT in advanced OSCC to compare the results with other treatment schemes using adjuvant RCT. Patients and Methods:A total of 183 patients with OSCC of UICC stages II-IVb were reviewed retrospectively. All patients were treated with radical surgery followed by adjuvant, conventional fractionated concomitant RCT using carboplatin. Overall survival was plotted by Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analysis. Results:Univariate analysis showed a significant impact of T, N, and UICC stage, histopathologic grading, surgical margins, extracaspular spread (ECS), and lymphangiosis carcinomatosa on overall survival (Table 3). Patients with stage IVa had a higher 5-year overall survival rate (42.8%) than patients with stage IVb (25.0%) (Figure 1). The differences were significant in multivariate analysis (p = 0.033) (Table 4). Conclusion:Adjuvant concomitant RCT is an effective treatment in patients with advanced stage OSCC. However, it remains unclear, which patients should be treated with adjuvant RCT. For patients with stage IVb, adjuvant RCT yields poor results. Prospective randomized trials are needed to confirm which patients should be treated with adjuvant RCT